AccountId: 011433970860
ContactId: 6769474d-0909-4e35-b6e6-50edfbeb3365
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 528080 ms
Total Talk Time (AGENT): 176968 ms
Total Talk Time (CUSTOMER): 172240 ms
Interruptions: 5
Overall Sentiment: AGENT=0.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/6769474d-0909-4e35-b6e6-50edfbeb3365_20250506T14:26_UTC.wav
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[AGENT][NEUTRAL] Hello, how may I assist you?
[CUSTOMER][NEUTRAL] Good morning. This is [PII] calling you from provider's office to check on a claim status.
[AGENT][NEUTRAL] Sure, ma'am, I could assist you with that. Can I have a callback number for you and that policy number?
[CUSTOMER][NEUTRAL] Yes, the number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And the policy number is it starts with D as in Delta 45402042.
[AGENT][NEUTRAL] I do apologize, [PII], but that's not a policy number here at American Public Life. Do you have that member's social?
[CUSTOMER][NEUTRAL] Uh, no, I do have a member's name if you want that.
[AGENT][NEUTRAL] Could you provide me with the spelling of the last name?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And what is the first name, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what city and state does [PII] live in?
[CUSTOMER][NEUTRAL] Uh, just give me a moment, let me check.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Can you verify [PII]'s date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and you're calling to verify claim status correct for what date of service?
[CUSTOMER][NEUTRAL] to the
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I can barely hear you, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, just give me a moment, OK? Just a second.
[AGENT][POSITIVE] So true
[CUSTOMER][NEUTRAL] Is it better now?
[AGENT][NEUTRAL] Yes, thank you. What is [PII]'s date of birth?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the date of service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII] for the bill amount, $334 even.
[AGENT][NEUTRAL] So this policy terminated [PII]. However, there is no claim on file for [PII].
[CUSTOMER][NEUTRAL] Uh, what is the policy effective date?
[AGENT][NEUTRAL] This policy has been active with effective [PII] and it terminated [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, uh.
[CUSTOMER][NEUTRAL] Uh, can you just uh repeat it one more time and can you just please go slow?
[AGENT][NEUTRAL] What do you need me to repeat the effective date of [PII] or the termination date of [PII]?
[CUSTOMER][NEUTRAL] OK. [PII], and then, so the patient is not actually on the service, right?
[AGENT][NEUTRAL] No, the member was not active if the policy terminated in [PII]. Your date of service is [PII].
[CUSTOMER][NEUTRAL] OK. OK. And how do you?
[CUSTOMER][NEUTRAL] OK, got it. And how do you spell your name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] And I do have 3 more claims. You can give me the call reference number for this one.
[AGENT][NEUTRAL] Is there anything else that I can assist you with today?
[AGENT][NEUTRAL] We don't provide reference numbers.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is it for the same patient?
[CUSTOMER][NEUTRAL] Again, what is the next one then.
[CUSTOMER][NEUTRAL] Uh, no, it is for different patients.
[AGENT][NEUTRAL] What is the next patient's policy number?
[CUSTOMER][NEUTRAL] Uh, it's the same it is D as in Delta 43473.
[AGENT][NEUTRAL] It's not, that's not a policy number here at American Public Life.
[CUSTOMER][NEUTRAL] Uh, OK. So I do see a medical APL and the policy number is 0258.
[CUSTOMER][NEUTRAL] 657-578.
[AGENT][NEUTRAL] OK, so what is the policy number? Could you give me the correct policy number?
[CUSTOMER][NEUTRAL] Yes, the correct policy number I see on the insurance card, it is 02.
[CUSTOMER][NEUTRAL] 586-578.
[AGENT][NEUTRAL] What is this member's name and date of birth?
[CUSTOMER][NEUTRAL] The member's name is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is the data service that you're calling to check the status of a claim for?
[CUSTOMER][NEUTRAL] [PII] for the bill amount, $330 even.
[AGENT][NEUTRAL] I'm not showing a claim on file for [PII] for this member.
[CUSTOMER][NEUTRAL] Uh, what is the policy effective rate of, of this patient?
[AGENT][NEUTRAL] This policy became active [PII] and it's currently active.
[CUSTOMER][NEUTRAL] OK, and can you just give me the uh mailing address?
[AGENT][NEUTRAL] Sure, give me one moment.
[AGENT][NEUTRAL] What was the date of service you said [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] The mailing address to submit a claim is [PII].
[AGENT][NEUTRAL] [PII] that's [PII].
[AGENT][NEUTRAL] [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK. And what is the payer ID?
[AGENT][NEUTRAL] 60, I'm sorry, 64556. That's 64556.
[CUSTOMER][NEUTRAL] OK, and what is the timely filing limit to submit a claim?
[AGENT][NEGATIVE] There is no timely filing. What is your next policy number?
[CUSTOMER][NEUTRAL] Uh, just a second.
[CUSTOMER][NEUTRAL] 20589631.
[AGENT][NEUTRAL] What is this? 20589631
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Can you verify that policy number because that's not a policy number. It's not pulling up a policy unfortunately.
[CUSTOMER][NEUTRAL] Let me check if I have the insurance card of the patient. No. Can you just verify it by the name or the date of birth or the social security number?
[AGENT][NEUTRAL] What is the social?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What is this member's name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And this is for medical?
[CUSTOMER][POSITIVE] Medical, correct.
[AGENT][NEUTRAL] So this member's policy is not here with American Public Life. Would you like for me to transfer you to Web TPA?
[CUSTOMER][NEUTRAL] OK. Is it FTPA?
[AGENT][NEUTRAL] Yes, this is Web TPA. This is American Public Life. Would you like for me to transfer you to Web TPA?
[CUSTOMER][NEUTRAL] Uh, no, I just have, I do, I have one more we can take that first and then we can, you can, yeah, uh, no, it's the same, I guess. Just give me a moment.
[AGENT][NEUTRAL] So let me give you the number to web TPA so that way you can call them and check the status of claim [PII]. That's [PII].
[CUSTOMER][NEUTRAL] OK. What is the number?
[CUSTOMER][POSITIVE] OK, no issue then. Thank you so much. Have a great day ahead. [PII], bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. You have a great one as well, [PII]. Goodbye.